A HEALER OF ITS OWN | Connie Shi

“Well, he has a very nice name. All dogs have a name …”

Ellen trailed off and looked at me with a puzzled, unreadable expression.

“What color is he?” I prompted. Although most hospitals don’t allow pets, that neverstopped Ellen’s canine companion from making frequent appearances, and I was curious to findout a little more about him.

“Brown,” she replied.

“And what type of dog is he?”

Ellen tugged at her frizzy white hair. “Well, normal size. Not too big.” Her gaze shiftedto the corner of the room. “Look, there he goes!”

I turned to look in the direction she pointed, knowing I would see nothing there.

Five years ago, Ellen began describing to her family images of dogs and cats, childrenplaying, and small cars driving themselves inside the house. Gradually, it became apparent thatin addition to the bizarre visuals she claimed to see, her memory was suffering too. Within a fewyears she could no longer take care of herself or make her own decisions. Memory problems,cognitive decline, and visual hallucinations – particularly of people and animals – are classicsymptoms of Lewy Body Dementia, a neurological condition that is unfortunately progressiveand presently incurable. I met Ellen and her mysterious pet dog after her memory issuesculminated in an accident that brought her to the hospital where I was a rotating medical student.

A few hours later, I came around to check on Ellen again. She was in the middle ofconversation, addressing the transparent form beside her.

“Now Murray, don’t you move from there.”

Hearing Ellen mention Murray generally made people uncomfortable. To the medicalteam, Murray was a symptom of the pathology that was irreversibly eating away at her synapsesand neurons. To Ellen’s son and daughter, Murray was another sign that their mother wasdrifting further into an unrecognizable reality, losing sense of her former self. Murray was anuncomfortable reminder of how much their mother had changed since her diagnosis, whichaffected not only her memory and thinking, but also the most essential elements of her mood andpersonality. I learned from Ellen’s children that while she had been extraordinarily eventemperedbefore dementia settled in, any slight provocation – from wearing an uncomfortablesweater to taking her medications – would now anger her, resulting in daily outbursts of cryingand screaming.

But Ellen never directed any anger toward Murray, I noticed. Nothing seemed toparticularly bother her during her one-sided conversations with the dog sitting dutifully at herfeet. In fact, Ellen was calmest when she spoke to him, chatting idly about one subject oranother. She delighted in watching him run back and forth, and in those moments, I saw in hereyes a true warmth and joy that was rarely evident otherwise. Murray’s presence seemed to coaxout the real Ellen, the Ellen that her dementia had stifled.

Murray appeared and disappeared erratically throughout the day, as hallucinations inLewy Body Dementia are apt to do. Yet he was often nearby, silently standing guard, when Ellenwas alone and at her most vulnerable. Ellen saw him perched near the window when she awokein the mornings. And at the end of the day, Murray was there with her when the door closed andshe clambered silently into bed.

I never asked Ellen whether she knew Murray wasn’t real. There wouldn’t be anymeaning in that question, because Murray was real enough. Not in a physical sense, and not in asense that I or any other observer could tangibly grasp. I couldn’t see Murray, but I couldperceive his form in her smile and serenity amid the confusion of her daily life. No scientificdiscovery or technological marvel could breach the strangeness of the universe that dementia hadconstructed for Ellen, but Murray brought the comfort of a mutual companionship, perhaps anequal therapeutic to anything that medicine could offer her at present.

Ellen’s convoluted reality – still indecipherable by modern medicine – had somehowcreated a healer of its own, indispensible to her survival in that world.

Connie Shi is a medical student at Harvard Medical School. She received her undergraduate degree from the University of Michigan, where she won the Department of Women’s Studies McGuigan Prize for her essay examining survivorship and breast cancer. Her narrative medicine essays have also appeared in KevinMD and the Journal of the American Geriatrics Society. "A Healer of Its Own" was chosen as an Honorable Mention in the 2016 Intima Essay Contest, “Patients, Providers and Pets: One Health for All,” a call for stories that reflect the term zooeyia, which has been coined to account for the salutary effects pets bestow upon humans.